{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T17:22:34Z","timestamp":1788628954346,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2016,4,15]],"date-time":"2016-04-15T00:00:00Z","timestamp":1460678400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>In 1992, Nepal passed the <jats:italic>Mother's Milk Substitutes (Control of Sale and Distribution) Act<\/jats:italic> in order to regulate the sale, distribution and promotion of substitutes for breastmilk within Nepal, in an effort to protect and promote breastfeeding. Helen Keller International, in collaboration with Nepal's Ministry of Health and Population's Child Health Division, implemented a study to assess mothers' exposure to promotions for and utilization of breastmilk substitutes in Kathmandu Valley, Nepal. A health facility\u2010based, cross\u2010sectional survey was conducted among 304 mothers being discharged after delivery. Prelacteal feeding of breastmilk substitutes is prevalent (55.9% of mothers, <jats:italic>n<\/jats:italic>\u2009=\u2009170). Reported recommendations during antenatal checks and after delivery from health professionals to use breastmilk substitutes were prevalent, occurring among 47.4% (<jats:italic>n<\/jats:italic>\u2009=\u2009144) of mothers; rates of these recommendations were significantly higher for mothers that delivered in private health facilities, as compared with public (67.7% vs. 38.0%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Mothers that received a recommendation to use a breastmilk substitute from a health worker were 16.7 times more likely to provide a prelacteal feed of a breastmilk substitute, as compared with mothers that did not receive a recommendation (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Few mothers reported observation of commercial advertisements for breastmilk substitutes inside a health facility (reported by 3.6% of mothers). No mothers reported receiving a sample of a breastmilk substitute, bottle or teat from a health professional. More information is needed to determine why there is such a high rate of health worker recommendations for breastmilk substitute use in the first few days after delivery.<\/jats:p><jats:p><jats:boxed-text content-type=\"box\" position=\"anchor\"><jats:caption><jats:title>Key messages<\/jats:title><\/jats:caption><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>While utilization of breastmilk substitutes is low among mothers of young children in Nepal, prelacteal feeding of breastmilk substitutes is highly prevalent in Kathmandu Valley.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Reported recommendations from health professionals to use breastmilk substitutes are common (over 40%) and are associated with prelacteal feeding among Nepal mothers included in this study.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Provision of lactation management training to health workers and monitoring their practices regularly could strengthen breastfeeding counselling, aid in reducing high rates of prelacteal feeding and contribute to improved infant feeding practices.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/mcn.12205","type":"journal-article","created":{"date-parts":[[2016,4,11]],"date-time":"2016-04-11T01:41:03Z","timestamp":1460338863000},"page":"8-21","source":"Crossref","is-referenced-by-count":19,"title":["Promotion and prelacteal feeding of breastmilk substitutes among mothers in Kathmandu Valley, Nepal"],"prefix":"10.1111","volume":"12","author":[{"given":"Alissa M.","family":"Pries","sequence":"first","affiliation":[{"name":"Helen Keller International Asia Pacific Regional Office  Phnom Penh Cambodia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra L.","family":"Huffman","sequence":"additional","affiliation":[{"name":"Consultant to Helen Keller International"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indu","family":"Adhikary","sequence":"additional","affiliation":[{"name":"Helen Keller International  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senendra Raj","family":"Upreti","sequence":"additional","affiliation":[{"name":"Ministry of Health and Population  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrid","family":"Dhungel","sequence":"additional","affiliation":[{"name":"Helen Keller International  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Champeny","sequence":"additional","affiliation":[{"name":"Helen Keller International  Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Zehner","sequence":"additional","affiliation":[{"name":"Helen Keller International  Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,15]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","first-page":"60","article-title":"Prelacteal feeding: influencing factors and relation to establishment of lactation","volume":"22","author":"Ahmed F.","year":"1996","journal-title":"Bangladesh Medical Research Council Bull"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1601385"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60937-X"},{"issue":"24","key":"e_1_2_9_5_1","first-page":"205","article-title":"Factors affecting complementary feeding practices of Nepali mothers for 6 months to 24 months children","volume":"11","author":"Chapagain R.","year":"2013","journal-title":"Journal of Nepal Health Research Council"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-S3-S19"},{"key":"e_1_2_9_7_1","unstructured":"Formhub.org(2013)Formhub. [online] Available at:http:\/\/formhub.org[Accessed 24 Apr. 2013]."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/38.6.317"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12126"},{"key":"e_1_2_9_10_1","volume-title":"Code Monitoring Kit","author":"IBFAN (International Baby Food Action Network)","year":"2007"},{"key":"e_1_2_9_11_1","unstructured":"Interagency Group on Breastfeeding Monitoring (IGBM) & United Nations Children's Fund (UNICEF)(2005)IGBM UNICEF UK Ministry of Health of Botswana and UNICEF Botswana Joint Project: monitoring of compliance with the International Code of Marketing of Breast\u2010milk Substitutes and subsequent World Health Assembly resolutions in Gaborone Botswana. Technical Country Report."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02751246"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2011.00384.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmr057"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2012.0115"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-4358-8-9"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-958"},{"key":"e_1_2_9_18_1","volume-title":"Nepal Demographic and Health Survey 2011","author":"Ministry of Health and Population (MOHP) Nepal, New ERA & ICF International Inc","year":"2012"},{"key":"e_1_2_9_19_1","volume-title":"Nepal Demographic and Health Survey 2006","author":"Ministry of Health and Population (MOHP) Nepal, New ERA & Macro International Inc","year":"2007"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD003519.pub3","article-title":"Early skin\u2010to\u2010skin contact for mothers and their healthy newborn infants","volume":"5","author":"Moore E.R.","year":"2012","journal-title":"Cochrane Database Systematic Review"},{"key":"e_1_2_9_21_1","unstructured":"Nepal Government (the then HMG)(1992)An Act Made to Control the Sale and Distribution of breastmilk Substitute. Act No. 39 of 2049 (1992\u2009A.D.). Kathmandu pp. Volume 42. 29th Mangshir 2049 (Supplementary 48)."},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/156482651003100222"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12267"},{"key":"e_1_2_9_24_1","volume-title":"Assessment and Strengthening the Implementation of the Code on breastmilk Substitutes and the Baby Friendly Hospital Initiative","author":"Shrestha P.S.","year":"2012"},{"issue":"190","key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.31729\/jnma.2117","article-title":"Knowledge and practice of postnatal mother in newborn care","volume":"52","author":"Shrestha T.","year":"2013","journal-title":"Journal of Nepal Medical Association"},{"issue":"1","key":"e_1_2_9_26_1","first-page":"1","article-title":"The effect of early initiation of breastfeeding on the amount of vaginal blood loss during the fourth stage of labor","volume":"79","author":"Sobhy S.I.","year":"2004","journal-title":"Journal of the Egyptian Public Health Association"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12128"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.112.170803"},{"key":"e_1_2_9_29_1","volume-title":"State of Breastfeeding and Complementary Feeding in Bangladesh","author":"Talukder M.","year":"1997"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-4358-7-1"},{"issue":"2","key":"e_1_2_9_31_1","first-page":"138","article-title":"Effect of early mother\u2010baby close contact over the duration of exclusive breastfeeding","volume":"7","author":"Vaidya K.","year":"2005","journal-title":"Nepal Medical College Journal: NMCJ"},{"key":"e_1_2_9_32_1","volume-title":"International Code of Marketing of Breast\u2010milk Substitutes","author":"World Health Organization","year":"1981"},{"key":"e_1_2_9_33_1","first-page":"1","volume-title":"Not Enough Milk","author":"World Health Organization","year":"1996"},{"key":"e_1_2_9_34_1","volume-title":"Indicators for Assessing Infant and Young Child Feeding Practices, Part 1\u2010Definitions: Conclusions of a Consensus Meeting Held 6\u20138 November 2007 in Washington D.C., USA","author":"World Health Organization","year":"2008"},{"key":"e_1_2_9_35_1","volume-title":"World Health Organization (WHO) & UNICEF (2003) Global Strategy for Infant and Young Child Feeding","author":"World Health Organization (WHO) & UNICEF","year":"2003"},{"issue":"2","key":"e_1_2_9_36_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1542\/peds.86.2.171","article-title":"Breast\u2010feeding frequency during the first 24\u2009hours after birth in full\u2010term neonates","volume":"86","author":"Yamauchi Y.","year":"1990","journal-title":"Pediatrics"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fmcn.12205","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.12205","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.12205","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.12205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T12:35:05Z","timestamp":1695990905000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.12205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4]]},"references-count":35,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2016,4]]}},"alternative-id":["10.1111\/mcn.12205"],"URL":"https:\/\/doi.org\/10.1111\/mcn.12205","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4]]}}}